psychiatric patients in mental health
EDUCATING PSYCHIATRIC patients about their illness and treatment for the purpose of increasing compliance with therapy, decreasing illness relapses and hospitalizations, strengthening social adaptation, and increasing quality of life is growing in importance. However, many studies reveal that patients do not have enough information about their medications and other therapy and they are noncompliant with therapy [Brown et al 1987, Schaub et al 2001 and Kelly et al 1990]. Researchers emphasize that the basic reason for lack of success in therapy is patients’ failure to take medications in the prescribed manner [Clary et al 1992, Seltzer et al 1980 and Eckman et al 1990].
Lithium is the medication used in the treatment and prevention of repetitive mood disorders and has side effects and danger of toxicity [Kearney and Meadows 1993, Lee et al 1992 and Mander 1988]. Despite this only a few studies were found related to medication compliance in patients who take lithium and in these studies they report that patients who take lithium have limited information about their medication [Lee et al 1992 and Dubyna and Quinn 1996] and emphasize the need for intensive patient education for patients who take lithium, in particular regarding side effects [Schaub et al 2001 and Lee et al 1992].
Recently psychoeducation therapy, which includes education about disorders and medications, has been increasing for psychiatric patients. There are many studies in the literature, which show the effect of informing psychiatric patients about their illness, treatment and medications on ensuring their compliance with therapy [Brown et al 1987, Kelly et al 1990, Seltzer et al 1980, Pollack 1995, Goulet et al 1993, Halford et al 1995, Harter et al 2002, Bruseker and O’Halloran 1999, van Gent and Zwart 1991 and Goldman and Quinn 1988]. However there are insufficient studies, which bring to light the effect of informing patients who take lithium about their treatment and medication on their adaptation to their illness and quality of life.
Psychiatric nurses have primary responsibility for patients’ attaining optimal living conditions after discharge, in their taking individual responsibility for their care and in using psychoeducational approaches. Psychotropic medications have an important contribution to psychiatric patients being able to attain independent living conditions. In medication therapy nurses are not just responsible for giving the medication, they are also responsible for evaluating the medication’s effect and side effects, increasing patients’ knowledge about the medication, and ensuring and supporting compliance [Dubyna and Quinn 1996, William 1989, Grimm 1986 and Farkas 1990].
The purpose of this study was to investigate the effects of disorder and medication education on patients’ compliance with the medication, symptom level, and quality of life in outpatients who have bipolar disorder and take lithium.
Method
Setting and subjects
The research was performed in Sivas, a province in Central Anatolia, Turkey in a psychiatric department of a university hospital. Patients who were diagnosed with bipolar disorder according to DSM-IV diagnostic criteria and who had taken lithium for a long time (1992–2002) were included in the study. Thirty-two patients who met the criteria were identified. These patients were set up in order, then they were selected according to order numbers, for example those with odd numbers constituted the study group and the others the control group. The purpose of the research was explained to all of the patients and informed consent was obtained. Six patients who had medication and address change during the implementation period were removed from the study and the study was performed with the remaining 26 patients, 14 in the study group and 12 in the control group.
Instruments
Data were obtained in the research using Personal and Disease Characteristics Information Form, Brief Symptom Inventory, Quality of Life Assessment, and Medication Information Questionnaire.
Tags: Patients Lithium